Provider Demographics
NPI:1053002428
Name:TRINITY HEALTH PACE OF ALEXANDRIA
Entity type:Organization
Organization Name:TRINITY HEALTH PACE OF ALEXANDRIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:PLAISANCE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, NFA
Authorized Official - Phone:318-206-1000
Mailing Address - Street 1:3403 GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-3321
Mailing Address - Country:US
Mailing Address - Phone:318-206-1000
Mailing Address - Fax:318-206-1099
Practice Address - Street 1:3403 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-3321
Practice Address - Country:US
Practice Address - Phone:318-206-1000
Practice Address - Fax:318-206-1099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY HEALTH PACE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization